Individual
DYRESHA WHITESIDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
11414 W PARK PL STE 202, MILWAUKEE, WI 53224-3500
(414) 716-6257
Mailing address
4776 W DEAN RD, MILWAUKEE, WI 53223-3120
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
169311
WI
163WH0200X
Home Health Registered Nurse
Primary
1234565658
WI
Other
Enumeration date
10/27/2014
Last updated
01/31/2017
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